Ginkgo and Colchicine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Colchicine
Ginkgo
No brand names on record
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Colchicine is a medicine your body normally clears out at a steady pace. Ginkgo (an herbal supplement) may slow down two of the pathways your body uses to break down and remove colchicine. When that happens, colchicine can build up to higher levels than intended, and that raises the risk of serious side effects like severe diarrhea, muscle weakness, and, in rare cases, dangerous toxicity.
Because colchicine is a medicine where even small increases matter, this combination is treated as one to avoid. The good news is your care team can help. Please don't stop or change anything on your own, just let your pharmacist or doctor know you take (or want to take) ginkgo so they can guide you safely.
Effect: Increased colchicine exposure with risk of serious, potentially fatal toxicity. Colchicine is an active drug (not a prodrug), so inhibition raises its levels.
Mechanism: Ginkgo may inhibit P-gp-mediated efflux and CYP3A4-mediated metabolism of colchicine, increasing AUC/Cmax.
Evidence: Probable; onset unspecified.
- Concomitant use with P-gp inhibitors is labeled contraindicated.
- If coadministration is necessary, reduce colchicine daily dose by 50-75% or reduce dosing frequency.
- Contraindicated in renal or hepatic impairment (fatal toxicity reported).
- Monitor for GI, myotoxic, and hematologic signs of colchicine toxicity.
What happens
Increased colchicine exposure and an increased risk of fatal toxicity
Interaction Deep Dive
The combined administration of colchicine with P-gp inhibitors is contraindicated1. When colchicine is taken together with CYP3A4 inhibitors that additionally inhibit P-gp, serious and potentially life-threatening toxicity may occur. Should it be necessary to give colchicine alongside a P-gp inhibitor, the colchicine dose ought to be modified, either by lowering the daily amount by 50% to 75% 3 or by decreasing how often it is dosed. Furthermore, giving colchicine at the same time as P-gp and CYP3A4 inhibitors is contraindicated in individuals with renal or hepatic impairment 3. In patients who have both renal and hepatic impairment, using these inhibitors together with colchicine has led to colchicine toxicity that was life-threatening or fatal 2.
Why it happens (mechanism)
Inhibition of P-gp-mediated efflux transport of colchicine; inhibition of CYP3A4-mediated metabolism of colchicine
How to manage this interaction
This combination is considered one to avoid because ginkgo can raise colchicine levels and increase toxicity risk. Here is how a care team typically handles it:
- They may recommend not combining the two, especially if you have any kidney or liver problems.
- If both are truly needed, your colchicine dose may be adjusted and individualized (often a lower dose or less frequent dosing) and you may be monitored more closely.
What you should do: Keep taking your colchicine exactly as prescribed and tell your pharmacist or prescriber that you use or are considering ginkgo. Report any severe diarrhea, muscle pain or weakness, numbness, or unusual weakness right away.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Ginkgo and Colchicine together?
Ginkgo can raise colchicine to dangerous levels, so this pairing is generally avoided; tell your pharmacist or doctor before combining them, especially if you have kidney or liver issues. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Ginkgo and Colchicine interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Ginkgo and Colchicine interaction managed?
This combination is considered one to avoid because ginkgo can raise colchicine levels and increase toxicity risk. Here is how a care team typically handles it: They may recommend not combining the two, especially if you have any kidney or liver problems. If both are truly needed, your colchicine dose may be adjusted and individualized (often a lower dose or less frequent dosing) and you may be mo… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Ginkgo or Colchicine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: LODOCO(R) oral tablets, colchicine oral tablets. AGEPHA Pharma USA, LLC (per FDA), Parsippany, NJ, 2023. DailyMed
- Product Information: MITIGARE(R) oral capsules, colchicine oral capsules. Hikma Specialty USA Inc (per FDA), Columbus, OH, 2024. DailyMed
- Hansten PD, Tan MS, Horn JR, et al: Colchicine drug interaction errors and misunderstandings: recommendations for improved evidence-based management. Drug Saf 2023; 46(3):223-242. PubMed
Keep reading about Colchicine
Keep reading about Ginkgo
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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